Jonathan Gruber, a prominent economist who helped create the state health plan in Massachusetts, told the panel he estimated that a 10 percent rise in the cost of the essential benefits package would increase the cost of government subsidies by 14.5 percent, or $67 billion, while reducing the share of the insured by 4.5 percent, or 1.5 million, through 2019.

And so begins the inevitable… special interests lining up to saddle the “essential benefit” package with all manner of goodies.

Thist is precisely the trouble with a mandate. It is impossible for there to be a government-required mandate without special interests lobbying to ensure their good or service is required as part of the package. This is why a uniform tax credit would be so much better. People would have a credit sufficient to cover the core insurance all of us needs; but would have to buy the bells and whistles with their own (preferably after-tax) dollars.

Will insurers be required to cover all the essential benefits, but have the freedom to restrict providers and the method of delivery so that it is extremely efficient (though not necessarily convenient to patients). E.g., mammograms covered at the one local location set up to process thousands of patients on the monthly mammogram day, prostrate exams covered on prostrate day, etc.?